Gutman Faces New Hmo Complaint

State officials have filed a second civil complaint charging state Sen. Alberto Gutman with brokering the sale of a Miami HMO without a license, a deal that earned the senator a $500,000 fee.

The Florida Department of Business and Professional Regulation complaint alleges Gutman illegally assisted in the sale of Max-A-Med Health Plans in September 1994 to a subsidiary of Physician Corporation of America. The state is seeking a $5,000 fine.

It is the second state suit in less than a month to accuse Gutman, former chairman of the Senate Health Care Committee, of violating state law by negotiating sales of South Florida Medicaid HMOs.

In late November, the state business department charged Gutman with two counts of illegally arranging the sale of St. John Medical Plans in Miami to PCA, Florida's biggest Medicaid HMO, and another company. That complaint, which is pending, seeks $10,000 in fines. The St. John deal fell through, and Gutman received no money.

"In our opinion this is brokering without a license, whether the sale was consummated or not," department spokesman Ed Towey said on Monday.

Under state law, Gutman has 21 days to respond to the charges, which he can settle or challenge through an administrative hearing.

Gutman on Monday denied wrongdoing and said he would fight the charges, which he said have "no basis."

Gutman said he worked as a management consultant to the HMO, rather than a broker.

"No one with the knowledge of all the facts regarding my role and management consulting contract with Max-A-Med agrees with the Department of Business and Professional Regulation," Gutman wrote in a prepared statement. "I know when I have the opportunity to present those facts, that it will be evident that all laws and regulations were fully complied with."

Gutman came under fire after the Sun-Sentinel disclosed the terms of the Max-A-Med sale in June. At the time, Gutman said he obtained permission from the Senate legal counsel to take the consulting job.

The Miami Republican resigned from the Health Care Committee in September in the wake of statewide news coverage of his financial ties to the HMO industry, which the committee oversees.

Documents released by the business department on Monday accuse Gutman of other questionable dealings within Florida's $670 million-a-year Medicaid HMO business.

The filings include minutes of an August 1994 meeting of the board of directors of Community Medical Plan, a Medicaid HMO that was up for sale at the time. In the minutes, a Community director said Gutman expected to receive a $1 million fee for arranging the sale of Community to PCA. He said Community should have considered compensating Gutman whether or not the sale went through because Gutman "had indicated that he could, with his Tallahassee connections, jeopardize any other potential deal" the company made.

Although Gutman received no money from Community Medical Plan, he did collect $500,0000 for his work with Max-A-Med in a single check dated Oct. 4, 1994, records show.

Max-A-Med, a Little Havana HMO formerly known as Clinica Fatima, had a long history of troubles with state insurance regulators who worried about its shaky finances.

The HMO had been owned by the family of state Rep. Bruno Barriero, R-Miami. But in 1993, some new investors emerged to bail it out.

The major shareholder, Isadore Schwartz, a Virginia real estate investor, recommended that the HMO hire Gutman to advise it on its business operations, company president Dr. Carolina Sierra told state investigators.

Gutman signed a contract with Max-A-Med in May 1994 that specified he was to "explore different alternatives" for refinancing or selling the HMO.

Sierra said that Gutman played no role in negotiating the sale to PCA. She told investigators that Gutman's primary duty was to assist the HMO in improving quality controls that could help the health plan win accreditation.